Background and Purpose. Mental practice has been shown to be effective in increasing the force production of the abductor digiti minimi muscle in the hand. The aim of this study was to determine whether mental practice could produce strength gains in the larger ankle dorsiflexor muscles, which are important during walking. Subjects. Twenty-four subjects were randomly assigned to a physical practice group, a mental practice group, or a control group (8 subjects per group). Methods. In the practice groups, subjects either physically or mentally practiced producing maximal isometric contractions for 3 sets of 10 repetitions, 3 times per week for 4 weeks. Changes in mean peak isometric torque normalized to body weight and the resulting percentage of improvement were analyzed across the 3 groups. Results. Differences in raw torque production after training in the 2 practice groups resulted in significant percentages of improvement for the physical practice group (25.28%) and the mental practice group (17.13%), but not for the control group (−1.77%). The 2 practice groups were not statistically different in their maximal torque-generating capacity after training. Discussion and Conclusion. These findings show that mental practice in people without impairments can lead to an increase in torque production similar to that produced by physical practice. Such a technique may prove to be a useful adjunct to traditional treatment options aimed at increasing muscle strength.

Background and Purpose. In an attempt to improve the gait of people with Parkinson disease (PD), researchers have examined the effect of visual cues placed on the floor. These studies typically have used a single session of training with such cues and have not examined the long-term carryover of such training. In the present study, therefore, gait was analyzed during uncued, cued, and retention phases, each lasting 1 month. Subject. A 78-year-old woman who had been diagnosed with PD 12 years previously (Hoehn and Yahr classification of disability, stage III) volunteered for the study. Methods. During the initial uncued gait phase, the subject was required to walk a distance of 10 m as many times as she could in 30 minutes, 3 times per week for 4 weeks. During the 4-week cued gait phase, visual cues were placed on the floor along the 10-m walkway. The cues were initially 110% of the uncued step length and were later increased to 120%. Following this cued gait phase, the subject’s gait was recorded periodically for 1 month without cues available. Step length, gait speed, and 2-dimensional lower-limb kinematics were compared within and across the 3 experimental phases. Celeration lines were calculated for the initial uncued phase and then extrapolated across the cued training and uncued retention phases. Binomial tests were used to analyze the significance of changes from the initial phase of the experiment. Results. Step length (0.53–0.56 m) and gait speed (0.77–0.82 m·s⁻¹) were essentially unchanged during uncued gait training after the first day; however, during the cued gait phase, gait speed improved, from 0.87 m·s⁻¹ to 1.13 m·s⁻¹, as step length was increased with visual cues. Improvements in step length (0.68 m) and gait speed (1.08 m·s⁻¹) were still evident 1 month following the removal of the cues. Analyses of angle-angle diagrams and phase-plane portraits revealed that training with visual cues increased hip and knee range of motion and engendered more stable motor control of the lower limb. Discussion and Conclusion. In contrast to previous studies in which the benefits of visual cueing were relatively short-lived, in this study, 1 month of gait training with visual cues was successful in establishing a lasting improvement in gait speed and step length while increasing the stability of the underlying motor control system. [Sidaway B, Anderson J, Danielson G, et al. Effects of long-term gait training using visual cues in an individual with Parkinson disease.

In healthy young adults motor learning is typically improved by practice under conditions of high contextual interference such as that created when a series of skills are practiced in a random sequence. The authors examined whether individuals with Parkinson's disease and age-matched older adults might also benefit from such a learning environment. Participants learned 3 peg placement movements under both random practice and blocked practice schedules. Participants completed free-recall, cued-recall, and transfer tests 1 day and 1 week following practice. During acquisition all learners had shorter movement times (MTs) during blocked than random practice but during retention testing, MTs were shorter if the patterns had been learned with random practice. Fewer errors during free recall following random practice were evident in both groups of learners and MTs to complete a novel transfer task were shorter following random practice. These findings suggest employing a cognitively challenging practice environment might improve motor skill learning in elderly learners and in people with Parkinson's disease.